Technical Management Trust Fund

TECHNICAL SCHOOL MANAGEMENT TRUST FUND INSTITUT SUPÉRIEUR DE TECHNOLOGIE Centre de Ressources Rue de la Concorde, Camp Levieux, Rose-Hill, Mauritius TELEPHONE: 467-4229 - FAX: (230) 466-4683 - e-mail: [email protected] - web site: http://pages.intnet.mu/ist

APPLICATION FOR ADMISSION TO PART-TIME COURSES For Office use Only

DIPLOME UNIVERSITAIRE SUPERIEUR DE TECHNOLOGIE (DUST) IN

 ‘ GENIE CIVIL’ (GC) or Reg. N°.  ‘MAINTENANCE ET AUTOMATISMES INDUSTRIELS’ (MAI) or  ‘GENIE ELECTRIQUE ET INFORMATIQUE INDUSTRIELLE’ (GEII) or Date Received: ……….………  ‘INFORMATIQUE APPLIQUEE’ (INFO)  Candidates should read the Notes of Guidance carefully before filling in this application form.  This form should be accompanied by photocopies of birth and educational certificates, relevant testimonials together with a non-refundable application fee of Rs 200. Field Applied for GC (PLEASE USE BLOCK LETTERS) (Please tick)

1. Surname: ………………………………………………………………………………………………………………… Other names: ……………………………………………………………… Maiden name (if married): …………………………………………… (Enclose photocopy of marriage certificate)

Telephone N°.

2. Address for correspondence:…………………………………………… Home: ………………………

……………………………………………………………………………….. Office:……………………….

……………………………………………………………………………….. Fax: ……………………………….

……………………………………………………………………………….. E-mail:……………………………………….

3. DATE OF BIRTH 4. SEX 5. MARITAL STATUS 6. NATIONALITY Day Month Year Male Female Married Single Mauritian If not Mauritian, specify

……………………..

7. EDUCATIONAL DETAILS (Note: Qualifications obtained after the closing date will not be considered.) Details of Secondary schools and / or other Educational Institutions attended. ENTERED LEFT INSTITUTIONS Month Year Month Year

……………………………………………………………… …………… …………… …………… ……………

……………………………………………………………… …………… …………… ……………. …………… 7.1. List all subjects already taken, including failures, in exactly the same order as presented in Certificate. Give the three best attempts for each certificate and their years and months of examinations. Group together all subjects taken at one sitting. For Office GRADES (e.g. 1,2,3…or A, B, C,) SC/GCE "O" LEVEL RESULTS Use only Date of attempt (Month / Year) 1st 2nd 3rd SUBJECTS Attempt Attempt Attempt 1 2 3 4 5 6 7 8 9 10 7.2 For Office GRADES (e.g. 1,2,3…… or A,B, C, …….) HSC/GCE A-LEVEL RESULTS Use only

Date of attempt (Month / Year) 1st 2nd 3rd SUBJECTS Attempt Attempt Attempt List all Subjects taken at Principal or Advanced Level 1 2 3 4 Subjects taken at Subsidiary Level 1 General Paper 2 3 4

7.3 OTHER QUALIFICATIONS Name of qualification: Overall Grade (Please tick) For Office Pass Credit Distinction Use only Institution: Other:………………………………….. Date of attempt (Month / Year) GRADES (e.g. 1,2,3…or A, B, C,) SUBJECTS 1st 2nd 3rd Attempt Attempt Attempt 1 2 3 4 5 6 7 8 9 10 7.4 Are you preparing for any other examination? Yes No If yes, indicate the course and approximate examination period. …………………………………………………………………………………………………………..

8. Give all relevant information about previous and present employment, if applicable. If you are not in any employment, give details of any relevant industrial training you may have undergone during your studies at school. (Relevant testimonials should be attached)

From To Name & Address of Position Job Description Month Year Month Year Employer/Firm Held

9. THIS SECTION MUST BE FILLED IN BY ALL APPLICANTS

I, ……………………………………………………………………………………, solemnly declare that if admitted to the Institute, I will diligently follow the course of study for which I am selected to its termination; that I will inform the Administration in writing and without delay, if I withdraw from the course; and that I will conform to all rules and regulations of the Institute. I certify that I will pay in advance all fees and dues required and I also declare that the above information is correct.

Date. ……/…/… Signature …………………………………….

For office use only Receipt N°. REMARKS

Name: ……………………

Date: ……………………

Signature: ……………….. NOTES OF GUIDANCE

Before filling in the Application Form You are strongly advised to read carefully the notes below

1. Courses will be around 1800 hours’ duration over a period of 7 semesters during the academic years starting in July 2005 and finishing in December 2008.. 2. An average of 12 hours of course per week is scheduled as follows:-  2 weekdays (3.30pm – 6.30pm) and  1 Saturday (9.00 am – 4.00 pm). Courses will be conducted in French. 3. Details of the course contents are available at the IST or on our website; candidates are advised to take note of these and to ensure that the course for which they are applying satisfy their needs. 4. Together with each Application Form duly filled in, you should submit a Photostat copy of each of your birth and educational certificates. Original certificates should NOT be submitted at the time of application but you have to produce these at the time of registration in case you are selected. 5. Candidates holding the "Brevet de Technicien" or "Baccalauréat Scientifique ou Technique" qualifications must submit a Photostat copy of their last end-of-term report. 6. Any other relevant information may be furnished on a separate sheet of paper if necessary. 7. Completed Application Forms together with all supporting documents and a non-refundable Application Fee of Rs 200 should be submitted in person on or before the 29 April 2005. 8. Applications received after the closing date or not supported by relevant documents will not be considered. 9. Photostat copies of certificates and other documents submitted will not be returned to candidates. 10. Two passport size photos are required upon registration 11. Candidates may have to appear for interviews. 12. Tuition fees (excluding examination fees) will be payable as follows:

Year Date Fees Amount/ Rs July 2005 Deposit* 10000 0 July 2005 1st Semester 17500 January 2006 2nd Semester 17500 1 July 2006 3rd Semester 17500 January 2007 4th Semester 17500 2 July 2007 5th Semester 17500 January 2008 6th Semester 17500 3 July 2008 7th Semester 7500 Total 122500

* Advance on fees (non-refundable)